Provider Demographics
NPI:1023167285
Name:FLOYD, WINSTON CORDELL (MD)
Entity type:Individual
Prefix:
First Name:WINSTON
Middle Name:CORDELL
Last Name:FLOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NORTH FANT STREET
Mailing Address - Street 2:SUITE G
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5720
Mailing Address - Country:US
Mailing Address - Phone:864-224-2197
Mailing Address - Fax:864-225-0033
Practice Address - Street 1:400 NORTH FANT STREET
Practice Address - Street 2:SUITE G
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5720
Practice Address - Country:US
Practice Address - Phone:864-224-2197
Practice Address - Fax:864-225-0033
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC073057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC073057Medicaid
SCP00831413OtherRR MEDICARE
SCPA3512Medicaid
D47045Medicare UPIN
SCPA3512Medicaid
SC7111Medicare PIN